Call for more help as mental health detentions rise

Call for more help as mental health detentions rise

THE number of times people were compulsorily detained for mental health treatment reached a record high last year, according to figures published today by a health watchdog.

They revealed that during 2014/15 provisions which enable doctors to deprive a person of his or her liberty and treat them against their will were used almost 5000 times – a seven per cent rise from the previous year and the highest level since 2005.

The figures were published in a report from the Mental Welfare Commission, which has a statutory duty to monitor the use of the Mental Health Act under which the measures were introduced and which obliges doctors to inform the Commission when they are used.

Colin McKay, chief executive of the commission, said the increase in new compulsory treatment was due to an increase in the use of the measures to admit older people suffering acute mental health crises to hospital.

His report found the numbers of emergency detention certificates, which allow patients to be detained for 72 hours, rose by 19 per cent for men and women aged between 65 to 84 year olds, while for the same age group there was also an 18 per cent increase in short-term detentions where patients can be kept in hospital against their will for 28 days.

McKay suggested the rise may be explained by a rise in mental health problems faced by older men and women and raised questions about whether they were getting appropriate levels of care in the community.

“I think it does say something about the needs of older people and the fact they are having to get compulsory treatment. It’s not just an issue about the ageing population but about also services responding to those people’s needs,” he said.

“Compulsory treatment should be a last resort. The whole point of the Act is that you should only go against the patient’s wishes if they get to the point where you absolutely have to and that everything else has been tried.”

Dr Gary Morrison, executive director (medical) at the Commission, added: “It could be a symptom of pressures on services or changes in services or changing attitudes in services. It could be people are being kept at home until they are in a greater state of crisis and by the time they need to be in hospital they are much more ill than they were.”

The Commission was also concerned about variations across Scotland in how compulsory treatment measures were being implemented.

The Act says where practical they should be used by doctors with the consent of a mental health officers, specialist social workers who may know the patient and may be able to suggest alternatives to compulsory hospital treatment.

But the report found there was a difference across health board areas in the levels of consent from MHOs, with Greater Glasgow and Clyde showing the lowest rate of having their consent.

In Greater Glasgow and Clyde, only 28 per cent of emergency detentions had such consent, compared with 80 per cent in Tayside and 60 per cent in Lothian.

McKay said he was concerned about the low rate of consent from mental health officers in some areas.

“One thing we are clear on, is that the pressure on mental health officers is continuing,” he said.

“It is unfair for vulnerable people to find that the area of the country in which they live plays such a central role when it comes to knowing whether they will get the support of these specially trained social workers in a crisis situation. They can help make a difficult and frightening situation a little bit easier, and may be able to find ways to avoid the use of detention altogether. We will push the Scottish Government and local authorities to do more to encourage more people to train for this role, and for more resource to go into supporting that training.”

An Age Scotland spokesman said: “Whilst the underlying reason for this increase is yet to be determined, we hope that the Scottish Government takes the advice of the Mental Welfare Commission into consideration to ensure that Mental Health provision for older people is the best it possibly can be to provide the necessary long-term support.”

Minister for Sport, Health Improvement and Mental Health, Jamie Hepburn said: “The MWC notes that the reason for the rise in compulsory treatment is unclear and may be due to increased diligence in using the legislation appropriately. We will continue to work with the Commission and stakeholders to promote patients’ rights, including through implementation of the Mental Health (Scotland) Act 2015.”

Regarding the disparity between health boards over whether there is consent from a specialist social worker, he added: “Consent by Mental Health Officers to people being detained under an Emergency Detention Certificate is an important safeguard and it is essential that it is applied appropriately by local authorities.

“We recognise the invaluable contribution made by MHOs to improving the lives of mental health patients and their friends and families.

“It is the responsibility of local authorities to plan their MHO workforce, ensuring they have the appropriate levels of staff in place to provide services for their residents.”

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